Department of Endocrinology, Key Laboratory of Diabetes Prevention and Control China-Japan Friendship Hospital, Beijing, China.
BMJ Open. 2013 Nov 4;3(11):e003325. doi: 10.1136/bmjopen-2013-003325.
To investigate the prevalence of microalbuminuria (MAU) among Chinese individuals without diabetes and the relationship between MAU and metabolic factors, individual socioeconomic status (SES), and regional economic development level.
Cross-sectional study of prevalence of MAU.
152 urban street districts and 112 rural villages from northeast, north, east, south central, northwest and southwest China.
46 239 participants were recruited using a multistage stratified sampling design from 2007 to 2008. A total of 41 290 participants without diabetes determined by oral glucose tolerance test were included in the present study. Urine albumin/creatinine ratio results of 35 430 individuals were available.
Positive detection of MAU was determined using an ACR of 22.1-299.9 mg/g in men 30.9-299.9 mg/g in women.
The prevalence of MAU in men was 22.4% and 24.5% in women. In developed, intermediate-developed and under-developed areas, the prevalence of MAU in men was 20.7%, 21.9% and 32.5%, respectively; in women the prevalence was 19.6%, 26.0% and 29.5%, respectively. The prevalence of MAU increased as the number of metabolic disorders present increased, and as the number of lower SES components increased (farmer, below university education level and low income). Prevalence of MAU in developed and intermediate developed areas had adjusted risk ratios of 0.52 (95% CI 0.42 to 0.60) and 0.65 (95% CI 0.57 to 0.76), respectively. Multivariate logistic analyses demonstrated MAU was strongly associated with older age, high-blood pressure, higher blood glucose low education level, low occupational level and residence in under-developed region.
Several factors had independent correlations to MAU in China: older age, metabolic abnormalities, lower SES level and living in economically under-developed areas, which encourage the development of strategies to lower the risk for MAU in these susceptible populations.
调查中国无糖尿病个体中微量白蛋白尿(MAU)的患病率,并探讨 MAU 与代谢因素、个体社会经济状况(SES)以及地区经济发展水平的关系。
MAU 患病率的横断面研究。
中国东北、北部、东部、中南部、西北部和西南部的 152 个城市街道区和 112 个农村村庄。
采用多阶段分层抽样设计,于 2007 年至 2008 年招募了 46239 名参与者。本研究共纳入 41290 名经口服葡萄糖耐量试验确诊无糖尿病的参与者。共有 35430 名个体的尿白蛋白/肌酐比值结果可用。
采用男性 30.9-299.9mg/g、女性 22.1-299.9mg/g 的 ACR 确定 MAU 的阳性检出率。
男性 MAU 的患病率为 22.4%,女性为 24.5%。在发达、中等发达和欠发达地区,男性 MAU 的患病率分别为 20.7%、21.9%和 32.5%,女性分别为 19.6%、26.0%和 29.5%。随着代谢紊乱数量的增加以及社会经济地位较低成分(农民、未受过大学教育和低收入)数量的增加,MAU 的患病率也随之升高。在发达和中等发达地区,MAU 的调整后风险比分别为 0.52(95%CI 0.42 至 0.60)和 0.65(95%CI 0.57 至 0.76)。多变量 logistic 分析表明,MAU 与年龄较大、高血压、高血糖、低教育水平、低职业水平以及居住在欠发达地区显著相关。
在中国,有几个因素与 MAU 独立相关:年龄较大、代谢异常、SES 水平较低以及生活在经济欠发达地区,这提示我们鼓励制定策略,以降低这些易感人群发生 MAU 的风险。